Fraud Control
The Health and Human Services Office of Inspector General issued an annual report on Medicaid fraud investigations. The report shows more than 1,000 open investigations into patient abuse or neglect at skilled nursing facilities. With 311 cases, nursing homes also led in open fraud investigations among inpatient and residential providers.
Overall in 2022, the Medicaid fraud units won 1,327 convictions, 381 for patient abuse and 946 for fraud. Convictions for patient abuse or neglect involved two provider types more than any others: nurse’s aides and nurses or physician assistants.
The False Claims Act has a requirement that nursing facilities report and return overpayments within 60-days of identification. The units also won 553 civil judgments last year. On the criminal side, they recovered $416 million, with another $641 million taken on the civil side.
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